Motor coordination difficulties are a common developmental occurrence. Often the difficulties reach beyond deficits in specific skills or abilities and impact more broadly on a child’s life at home, school and at play. The motor difficulties can result in a child’s inability to participate or avoidance of participation, in childhood activities or school tasks, affecting social, emotional and behavioural aspects. Long-term outcomes of children with developmental motor coordination difficulties, which affect a large number of adolescents and adults, have been well documented in the literature. Traditional therapy has tended to focus on a therapist driven, short term approach. Intervention outcome research has often been inconclusive or lacking framework.
This study set out to investigate the efficacy of physiotherapy intervention that combines a child and family centred therapy approach, focusing on the child as a whole and based on child and family driven goals, for children with motor coordination problems. This intervention model emphasizes
motivation and enhancement of self-confidence, in order to optimize the child’s experiences, so as to achieve improvements of functional skills and a mediating benefit on the child’s perception and self-confidence.
Seventeen children, aged between 7years 6 months to 10 years 6 months, who attended a community based child development unit and were described as having motor coordination difficulties by their parents (or guardians) and/or school, were recruited for this study. All children participating in the study satisfied inclusion criteria.
Multiple assessments were used to evaluate motor function and goal outcomes, child perception of competency and satisfaction, and parent perception of competence, behaviour and satisfaction. The design used in this study was a two group cross-over design which allowed for one group (for the first three month period) to act as the study’s controls. The groups received either intervention or no intervention (for three months, or 10 sessions), with the non intervention group acting as the ‘baseline’ group. After approximately three months, the groups crossed-over so that at the end of the study both groups had received periods of intervention and no intervention.
Overall the intervention framework was accomplished, and the planned comparisons achieved with varied results.
Results on the standardized motor assessment (M-ABC) showed significant improvement (p<0.05) for one group but not the other after intervention. Similarly, results on the behaviour and competence scales differed between the groups with gains seen in group 1. Improvements on the Goal Attainment Scaling as well as performance and satisfaction outcomes after intervention were significant for both groups. In addition, parents’ perception of their child’s performance and satisfaction with that performance was also measured and outcomes after intervention were improved for both groups. These improvements were maintained over a period of three months of non-intervention.